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. 2023 Feb;32(2):473-493.
doi: 10.1007/s11136-022-03205-z. Epub 2022 Aug 4.

Assessment of health-related quality of life in Australian patients with idiopathic pulmonary fibrosis: a comparison of the EQ-5D-5L and the AQoL-8D

Ingrid A Cox  1   2 , Julie Campbell  1 , Barbara de Graaff  1   2 , Petr Otahal  1 , Tamera J Corte  2   3   4 , Yuben Moodley  2   5   6   7 , Peter Hopkins  2   8   9 , Sacha Macansh  10 , E Haydn Walters  1   2 , Andrew J Palmer  11   12
Affiliations

Assessment of health-related quality of life in Australian patients with idiopathic pulmonary fibrosis: a comparison of the EQ-5D-5L and the AQoL-8D

Ingrid A Cox et al. Qual Life Res. 2023 Feb.

Abstract

Purpose: Idiopathic pulmonary fibrosis (IPF) is a progressive and debilitating chronic lung disease with a high symptom burden, which has a substantial impact on health-related quality of life (HRQoL). Our study aimed to assess the suitability of the EuroQol five-dimension (EQ-5D-5L) and the Assessment of Quality of Life- eight-dimension (AQoL-8D) questionnaires in measuring HRQoL as health state utility values (HSUVs) in an Australian IPF cohort.

Methods: Data for estimation of health state utility values (HSUVs) were collected from participants of the Australian IPF Registry (AIPFR) using self-administered surveys which included the EQ-5D-5L and the AQoL-8D. Data on lung function and disease specific HRQoL instruments were collected from the AIPFR. Performance of the two instruments was evaluated based on questionnaire practicality, agreement between the two instruments and test performance (internal and construct validity).

Results: Overall completion rates for the EQ-5D-5L and AQoL-8D were 96% and 85%, respectively. Mean (median) HSUVs were 0.65 (0.70) and 0.69 (0.72) for the EQ-5D-5L and AQoL-8D, respectively. There was reasonable agreement between the two instruments based on the Bland-Altman plot mean difference (-0.04) and intraclass correlation coefficient (0.84), however there were some fundamental differences. A larger range of values was observed with the EQ-5D-5L (-0.57-1.00 vs 0.16-1.00). The EQ-5D-5L had a greater divergent sensitivity and efficacy in relation to assessing HSUVs between clinical groupings. The AQoL-8D ,however, had a higher sensitivity to measure psychosocial aspects of HRQoL in IPF.

Conclusion: The EQ-5D-5L demonstrated superior performance when compared to AQoL-8D in persons with IPF. This may be attributable to the high symptom burden which is physically debilitating to which the EQ-5D-5L may be more sensitive.

Keywords: AQoL-8D; EQ-5D-5L; Health-related quality of life; Idiopathic pulmonary fibrosis; Utility values.

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Conflict of interest statement

TC reports grants and personal fees from Boehringer Ingelheim, grants and personal fees from Roche, grants and personal fees from BMS, personal fees from Promedior, personal fees from Ad Alta, grants from Avalyn Pharma, grants from Biogen, outside the submitted work. All other authors declare that they have no financial/competing interests.

Figures

Fig. 1
Fig. 1
Distribution of scores for AQoL-8D, EQ-5D-5L and EQ-VAS
Fig. 2
Fig. 2
Bland Altman plot for differences in means for AQoL-8D and EQ-5D-5L utilities
See this image and copyright information in PMC

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